Method of obtaining data related to hearing ability with automatic delivery of corrective instructions

ABSTRACT

A method for obtaining data related to the hearing ability of a subject includes outputting tones or sounds, monitoring the subject&#39;s responses to the tones or sounds, detecting an error condition based on the responses, automatically delivering corrective instructions based on the error condition detected, and resuming the outputting of tones or sounds. The steps of outputting, monitoring, detecting, automatically delivering and resuming are iterated until the data related to the hearing ability of the subject has been obtained.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application is a continuation of Ser. No. 10/156,415, filed May 28,2003, which is a continuation of application Ser. No. 09/139,858, filedAug. 25, 1998, now U.S. Pat. No. 6,416,482, which is a continuation ofapplication Ser. No. 08/639,694, filed Apr. 29, 1996, now U.S. Pat. No.5,811,681.

BACKGROUND OF THE INVENTION

The present invention relates to a multimedia interface of a diagnostictest instrument and, more particularly, to automated testing, includingmultimedia-derived instructions, test monitoring, and error response, byan audiometer or other medical or diagnostic test instrument.

A wide variety of medical and diagnostic test instrumentation is known.An example of such instrumentation is an audiometer. The audiometer isan electrically activated generator of test tones for evaluation ofhearing. Other medical and diagnostic instrumentations include aspirometer for measuring lung capacity, vision testing equipment, bloodalcohol testing equipment, and occupational health industry maintenancetesting equipment, such as blood pressure, EKG, and other wellnesstesting equipment. Generally, these and other prior testinginstrumentations require one or more individuals to administer the testby operating the equipment and giving instructions to the test subject.

The trend in testing, however, appears to be toward automation. Throughautomation, reduced numbers of test administrators may be required andincreased accuracy of testing, with lack of deviation caused by humanadministrator error, may be possible. Although certain limitedautomation has previously been possible, that automation has beendirected primarily to the automated compilation, organization, andreporting of data in desirable formats. Processing units, such as, forexample, personal computers, have previously been employed to achievethe automation of the compilation, organization, and reportingfunctions. Little automation, if any, has previously been achieved,however, in connection with the actual administration of the test.Administration of such tests has typically been performed almost whollyby one or more human test administrators.

Hearing testing has for several decades been performed utilizing aninstrument called an audiometer. Prior to the audiometer, tuning forksand other tone generating devices were employed. In the early testing, atest subject responded directly to a test administrator who recordedtest results based on the administrator's subjective determinations. Theadvent of the audiometer, an electronic instrument that generates tones,provided a degree of standardization in hearing testing because uniformtones and proper calibrations are better achieved.

Even after the invention of the audiometer, however, hearing testing wasfar from standardized, as testing varied in both procedures anddeterminations. A standardized procedure, still followed today, was thendeveloped for hearing testing. That procedure is referred to as the“Hughson-Westlake” procedure. Other procedures are followed in someinstances, but the Hughson-Westlake procedure is probably the mostcommon.

In the Hughson-Westlake procedure, tones at a level audible to the testsubject, such as, for example, 30dB, are first presented to the subject.The test subject responds that the tones are heard, and then the levelof the tones are reduced by 10 dB. This is repeated with the testsubject responding that the tones are heard followed by 10 dB reductionsuntil the test subject's response (or lack of response) indicates thatthe tones are not heard. When the test subject so responds that thetones are not heard, the tone level is raised 5 dB. If the test subjectdoes not then respond, the level is raised another 5 dB, and this isrepeated until the test subject signals that the tone is heard. Thisentire process is repeated until the test subject has three ascendingpositive responses at the same level. In order to make comparison ofhearing quality over time, a first test is administered to establish abase line hearing level and later testing, undertaken at subsequent timeintervals, provides results for comparison to base line. The comparisonindicates any hearing loss or other changes over time.

As with diagnostic and industrial health testing instruments, generally,audiometers have progressed towards more automation. Also as with otherinstruments, however, automation of audiometers has typically focused oncompilation, organization, and reporting of test results. The automationhas not been directed to replacement of a human test administrator (orat least the additional functions of such an administrator) by a machineautomated process.

As previously mentioned, automation, particularly by a machine such as acomputer, achieves certain advantages in particular, the testing maybemore uniform among subjects and test periods, whereas testing is subjectto variation when a human test administrator administers and grades thetest. Also, supplying human test administrators to conduct tests israther costly. Reducing the required number of test administratorsthrough further automation of testing procedures may reduce or eliminatethose costs. Furthermore, test presentation and determined results mayvary among human test administrators. More standardized and accuratetesting maybe possible if intervention of a human test administrator isreduced through further automation. In addition to those advantages,certain automation may provide added advantages, for example,multi-lingual test administration, multiple simultaneous differenttests, multiple simultaneous test subjects, visual features, and otherpossibilities.

Embodiments of the present invention provide advantages of multimediaautomation in diagnostic testing employing electronic or otherinstrumentation. The embodiments are particularly suited in the case ofan audiometer, however, numerous other applications of the embodimentsare possible. The above-described advantages, as well as otheradvantages, are achieved through the embodiments. The present inventionis, thus, a significant improvement in the art and technology.

SUMMARY OF THE INVENTION

An embodiment of the invention is a method for automatedly administeringan audiometric test. The method comprises the steps of controlling anaudiometer to selectively switch the audiometer output between testtones generated by the audiometer and sound signals generated fromdigital information, first switching the audiometer output to soundsignals when the step of controlling indicates a beginning of a newtest, a completion of a current test, or a test error, outputting soundrepresentative of the sound signals after the step of first switching,second switching the audiometer output to test tones after the step ofoutputting, and outputting test tones until the next step of firstswitching.

Another embodiment of the invention is a multimedia audiometer. Themultimedia audiometer comprises means for outputting sound signalsgenerated from digital information, means for outputting test tones,means for switching between the means for outputting sound signals andthe means for outputting test tones, and means for controlling the meansfor switching, the means for controlling being communicatingly connectedwith the means for switching. The means for switching is communicatinglyconnected with the means for outputting sound signals and the means foroutputting test tones.

Yet another embodiment of the invention is a multimedia audiometer. Themultimedia audiometer comprises a computer, a tone generator, and aswitch connected with the computer and the tone generator. The switchselectively causes either the tone generator or the computer to outputsound waves, and the computer controls the switch.

Another embodiment of the invention is an audiometer. The audiometercomprises a processor, a memory, communicatingly connected with theprocessor, for storing digital data, a sound wave generator, forgenerating analog sound signals in respect of digital data, electricallyconnected with the processor, a test tone generator electricallyconnected with the processor, and a switch connected with the sound wavegenerator, the test tone generator, and the processor. The switch iscontrolled by the processor to selectively cause either the sound wavegenerator or the test tone generator to output sound waves.

A further embodiment of the invention is an instrument that conducts atest protocol on a test subject. The test protocol comprises an outputby the instrument followed by an input to the instrument. The testsubject determines the input, which input may be positive, negative, ornull. The instrument comprises an output generator, an input detectorfor detecting the input, a digital data storage for storing a digitaldata, a multimedia converter, the multimedia converter converts thedigital data to an analog signal, and logic circuitry connected to theinput detector, the digital data storage, the multimedia converter, andthe output generator, for logically operating on the input, reading thedigital data, delivering the digital data to the multimedia converter,and controlling the output generator.

Yet another embodiment of the invention is a multimedia audiometer. Themultimedia audiometer comprises a basic audiometer, a computer, amultimedia input interface communicatingly connecting the computer andthe basic audiometer, and a communications interface communicatinglyconnecting the computer and the basic audiometer.

Another embodiment of the invention is a diagnostic instrument. Thediagnostic instrument comprises means for outputting an audible sound,means for generating a test tone, means for storing a digital data,means for generating an analog signal derived from the digital data,means for switching an output of the means for outputting between thetest tone and the analog signal, the means for switching beingelectrically connected to the means for generating a test tone and themeans for generating an analog signal, means for processing, means forinputting, the means for inputting connects the means for processing tothe means for outputting, and the means for communicating, the means forcommunicating connects the means for processing to the means foroutputting, the means for generating the test tone, the means forstoring the digital data, the means for generating the analog signal,the means for switching, and the means for inputting.

Yet another embodiment of the invention is a method of performing adiagnostic test protocol. The method comprises the steps of outputtingan audible sound, generating a test tone, storing a digital data,generating an analog sound derived from the digital data, switching theaudible sound from the step of outputting between the test tone and theanalog signal, processing the digital data, and controlling the steps ofoutputting, generating the test tone, storing, generating the analogsound, and switching.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a functional block diagram of a conventional audiometer;

FIG. 2 is a detailed schematic of a typical audiometer, corresponding tothe functional block diagram of FIG. 1;

FIG. 3 is a schematic of a talkover card for use with the audiometer ofFIG. 2;

FIG. 4 is a block diagram of an audiometer interfaced with a personalcomputer for multimedia automation of audiometer testing;

FIG. 5 is a functional block diagram of an audiometer interfaced with amultimedia personal computer;

FIG. 6 is a schematic of the personal computer connection with thetalkover card of FIG. 3, to provide multimedia automation of audiometertesting; and

FIG. 7 is a flow diagram of a protocol for audiometric testing utilizingthe multimedia features of the embodiments of the present invention toautomate the test process.

DETAILED DESCRIPTION

Referring to FIG. 1, a functional block diagram of a conventionalaudiometer 2 maybe described. Although the following discussionprimarily addresses embodiments of the present invention employed for anaudiometer, the embodiments have varied application in a wide variety ofmedical and diagnostic instrumentation. All those applications areintended as included within the scope of the invention. Also, thefollowing describes various embodiments of the present invention asparticularly employed with the conventional audiometer 2. It is to beunderstood that the conventional audiometer 2 is detailed only forexample purposes, and all other alternative audiometer configurations,as well as other instrumentation and configurations thereof, are alsoapplications for the invention in accordance with the principles herein.

Conventional Audiometer

The conventional audiometer 2 is generally comprised of three parts:microprocessor circuitry 4, audio circuitry 6, and certain optionalelements 8. In addition to those three parts, the conventionalaudiometer 2 includes a power supply and related elements not shown inthe functional block diagram. One example of the conventional audiometer2 is the RA250 Microprocessor Audiometer available from TREMETRICS,Inc., Austin, Tex. Of course, as previously mentioned, the conventionalaudiometer 2 illustrated is shown only for purposes of illustration andexample. Other audiometers and other types of medical and diagnosticinstrumentation are also within the scope of the invention.

Microprocessor Circuitry

The microprocessor circuitry 4 of the conventional audiometer 2 mayinclude a processing unit (CPU) 12, such as, for example, an Intel™ 8085microprocessor or another microprocessor. The CPU 12 serves tocoordinate and control operations and functions of the conventionalaudiometer 2. The CPU 12 conductively connects with various memory, suchas, for example, erasable programmable read only memory (EPROM) 14 andrandom access memory (RAM) 16. The memory 14,16 may serve to store asoftware protocol which controls the CPU 12 to cause the conventionalaudiometer 2 to provide audiometric functions. The memory 14, 16 mayalso serve to maintain certain variables to achieve desired operationsand calibration of the conventional audiometer 2, or simply to providestorage for values made available to and from the CPU 12.

In addition to the memory 14, 16, the CPU 12 conductively connects withvarious input and output ports and peripherals. Input and output portsmay include a serial I/O port 22 and a parallel interface 24. The serialI/O port 22 may provide connections for certain optimal elements 8, ashereinafter discussed. The parallel interface 24 may connect with aninput device, for example, a keyboard 20. The parallel interface 24 mayalso connect with the audio circuitry 6, as later explained. Anotherinput device, such as a display 18, for example, may connect with thememory 14, 16, CPU 12, and other features of the microprocessorcircuitry 4. Such other features of the microprocessor circuitry 4 mayinclude, for example, certain programmable registers 26 and otherelements.

Audio Circuitry

Now discussing the audio circuitry 6 of the conventional audiometer 2,the audio circuitry 6 interfaces with the microprocessor circuitry 4 inseveral ways. The programmable registers 26 may serve as ports thatconnect with an oscillator (also “frequency generator”) 30. Theoscillator 30 may provide timing for a sine wave generator 32 thatproduces a digitally synthesized sine wave from which audible test tonesare derived. Because the sine wave generator 32 produces a digitallysynthesized wave, the wave may be smoothed by a low pass filter 34.

The low pass filter 34 may conductively interface with the parallelinterface 24 of the microprocessor circuitry 4. Other elements of theaudio circuitry 6, such as frequency selector 36, an electronicattenuator 38, a pulse control 40, a relay control attenuator 42, and ahandswitch jack 44, may conductively connect with the parallel interface24 to complete the interface of the audio circuitry 6 with themicroprocessor circuitry 4 of the conventional audiometer. Pursuant tothis interface arrangement, the audio circuitry 6 and the microprocessorcircuitry 4 may communicate signals for control and other purposes.

In addition to the connection of the low pass filter 34 with theparallel interface 24, the low pass filter 34 may conductively connectwith frequency compensation circuitry, such as, for example, a frequencyselector 36 that, together with the control provided through theparallel interface 24, helps compensate for attenuation. Other elements,such as the electronic attenuator 38 which connects with the frequencyselector 36, also provide compensation for attenuation. The sine winegenerator 32 feeds the pulse control 40 which, together with input tothe pulse control 40 from the electronic attenuator 38, delivers signalsrepresentative of desired test tones to a power amplifier 46. The poweramplifier 46 feeds the relay control attenuator 42 for left and rightearphone signals. The relay control attenuator 42 is conductivelyconnected with an earphone jack 48.

In order to allow a test subject to interface with the audio circuitry6, earphone speakers 50 and a handswitch 52 maybe provided. The earphonespeakers 50 may plug into the earphone jack 48. The test subject wearingthe earphone speakers 50 will then receive test tones generated by theconventional audiometer 2. The handswitch 52 may plug into thehandswitch jack 44. The handswitch 52 provides means for the testsubject to interface with the conventional audiometer 2 in order tosignal to the conventional audiometer 2 that the test subject eitherdoes or does not correctly receive test tones through the earphonespeakers 50.

Options

In addition to the basic elements just described, the conventionalaudiometer 2 may include certain optional elements 8. Various optionalelements 8 are possible, depending upon desired operations andfunctions. Two common optional elements 8 of the conventional audiometer2 have been an RS232 port 8 a and a talkover card 8 b. The RS232 port 8a may conductively connect to the serial I/O port 22 to allowcommunications of the microprocessor circuitry 4 with externalperipherals (not shown) connected with the RS232 port 8 a. Examples ofexternal peripherals which may connect to the RS232 port 8 a may includeprinters, terminals, and modems. The RS232 standard and suitableconnections to ports conforming thereto are generally known.

The other of the common optional elements 8, the talkover card 8 b, isof particular significance in embodiments of the present invention. Thetalkover card 8 b is conductively connected with the audio circuitry 6of the conventional audiometer 2 between the relay control attenuator 42and the earphone jack 48. In effect, the talkover card 8 b serves as aswitch to divert input to the earphone jack 48 when desired by a humantest administrator (not shown). The human test administrator mayselectively “throw” the switch and cause the input to the earphone jack48 to switch from signals from the relay control attenuator 42representative of test tones to signals representative of the human testadministrator's instructions then being voiced. Details of the talkovercard 8 b are hereinafter more fully discussed with respect to FIG. 3.

Referring now to FIG. 2, a detailed schematic of the conventionalaudiometer 2 of FIG. 1 is shown. Those skilled in the art willunderstand and appreciate the electrical elements and connectivities ofthe detailed schematic.

Referring now to FIG. 3, a detailed schematic is provided of thetalkover card 8 b of the conventional audiometer 2. The talkover card 8b comprises a fixed gain operational amplifier 60. A voice microphone 62is an input to the amplifier 60. Other common electronic elements, suchas, for example, resistors, capacitors, and others, may be included inthe circuitry of the talkover card 8 b. The amplifier 60 is connected tothe input to the earphone jack 48 of the audio circuitry 6 of theconventional audiometer 2 (shown in FIG. 1) by a relay 64 a. When ahuman test administrator wishes to deliver voice sounds, rather thantest tones, to a test subject wearing the earphone speakers 50 pluggedinto the earphones jack 48 (shown in FIG. 1), the test administratorcauses the relay 64 a to be thrown. The test administrator, by suchaction, simultaneously causes the conventional audiometer 2 to interruptthe test then in progress, discontinuing test tone generation.

Referring to FIGS. 1-3, in conjunction, the relay 64 a when so thrownconnects the amplifier 60, across switches 66 a, to the input to theearphone jack 48. In particular, electrical connector 68 passes thevoice signals from the amplifier 60 to the earphone jack 48 for deliverythrough the right ear speaker of the earphone speakers 50 and electricalconnector 70 similarly passes the voice signals to the left ear speaker.When relay 64 a results in closure of its switches 66 a, relay 64 bresults in opening of its switches 66 b, and vice versa. In this manner,either voice signals through the talkover card 8 b or test tone signalsthrough the audio circuitry 6 at any instant, but not bothsimultaneously, is delivered through the earphone speakers 50. As thoseskilled in the art will understand and appreciate, this design of theconventional audiometer 2 has allowed a human test administrator tointerrupt test tone testing to give instructions, error messages, andother voice commands. The conventional audiometer 2 has requiredintervention of a human test administrator, however, by selectivelythrowing relays 64 a,b and speaking into microphone 62 of the talkovercard 8 b, in order to conduct hearing test with intermittentinstructions and messages.

Multimedia Embodiments

Referring now to FIG. 4, a multimedia audiometer 100, according toembodiments of the present invention, maybe described. The multimediaaudiometer 100 includes a basic audiometer 200 having the basic elementsof the conventional audiometer 2 (shown in FIG. 1). That is, themultimedia audiometer 100 is also comprised of the microprocessorcircuitry 4 and the audio circuitry 6 (or other similar processing andaudio electronics and circuits) of the conventional audiometer 2 (shownin FIG. 1). The earphone speakers 50 and the handswitch 52 are alsointerfaced with the basic audiometer 200.

Although the multimedia audiometer 100 and the conventional audiometer 2share these similar basic elements, the basic audiometer 200 is merely asubset of the entire multimedia audiometer 100, as is apparent in FIG.4. In addition to the elements of the basic audiometer 200, 2, themultimedia audiometer 100 includes a computer 102, such as a personalcomputer, another type of computer, or some other processing and storagedevice. The computer 102 maybe equipped and connected with peripherals,such as a keyboard 106 and a display monitor 104, as well other knowninput/output, communications, printing, and peripheral equipment. In anyevent, the computer 102 should have multimedia capabilities, that is,the computer 102 should be capable of producing sound waves and/orvisual images from representative digital information stored, generated,and/or manipulated within or by the computer 102.

The computer 102 may be conductively connected with the basic audiometer200 through two interfaces: a communications interface 108 and amultimedia input interface 110. The communications interface 108 mayallow for serial, parallel, or other communications. If communicationsare serial, the communications interface 108 may connect the computer102 with the RS232 port 8 a (shown in FIG. 1) in standard manner, asthough the basic audiometer 200 is peripheral to the computer 102. Themultimedia input interface 110 requires, however, that the conventionalaudiometer 2 be modified in certain respects to provide the basicaudiometer 200 for multimedia automation of testing, as hereafterdescribed.

Referring now to FIG. 5, the communications interface 108 and themultimedia input interface 110 connect the computer 102 with the basicaudiometer 200 to form the multimedia audiometer 100, as shown infunctional block form. A serial input/output port (not shown in detail)of the computer 102 may directly connect via the communicationsinterface 108 with RS232 port 8 a of the basic audiometer 200. Amultimedia output port (not shown in detail) of the computer 102 maydirectly connect via the multimedia input interface 110 with amultimedia talkover card 118 b, similar to the talkover cord 8 b (shownin FIG. 3) of the conventional audiometer 2. The multimedia output portof the computer 102 may, for example, be a port of a sound card (notshown in detail) from which sound signals are output by the computer102. Alternatively or additionally, other multimedia outputs (not shown)of the computer 102, for example, graphical image or video outputs, mayconnect with the multimedia input interface 110 in similar manner. Thetalkover card 8 b (shown in FIG. 3) of the conventional audiometer 2configuration has not previously provided aport for connection of themultimedia input interface 110. The conventional audiometer 2 may,therefore, be adapted to provide such port. The adapted conventionalaudiometer 2 is the basic audiometer 200.

Referring now to FIG. 6, a sound port 120 of a multimedia talkover card118 b for multimedia input to the basic audiometer 200 may be described.The sound port 120 connects with the multimedia input interface 110, sothat multimedia outputs of the computer 2 are in put to the multimediatalk over card 118 b. The soundport 120 may include a connector 120 a towhich the multimedia input interface 110 maybe plugged. The connector120 a may be attached with two input leads 120 b. The input leads 120a,b may be attached with an audio jack plug 121. The audio jack plug 121is insertable in an audio jack 122 connected to the amplifier 60 output.When the audio jack plug 121 not is inserted in the audio jack 122, theoutput of amplifier 60 is shorted prior to the switches 66 a. When theaudio jack plug 121 is inserted in the audio jack 122, however, thecircuit is completed and the computer 102 connected to the sound port120 may supply multimedia input to the switches 66 a. In effect, themicrophone 62 is substituted with the multimedia input via the soundport 120. All other features of the multimedia talkover card 118 b aresubstantially the same as the features of the talkover card 8 b of theprior technology.

Although the input leads 120 b of the sound port 120 are shown asconnected with an output of the amplifier 60 in Figure, alternatively,the input leads 120 b could in similar manner connect with inputs to theamplifier 60 or at some other location prior to or after the amplifier60. Furthermore, although the multimedia talkover card 118 b isexpressly described as a “card” to the basic audiometer 200, it is to beunderstood that any other functional elements and circuitry that performsimilarly, such as, for example, a relay circuit that switches betweenthe tone generator of the basic audiometer 200 and the multimedia outputfrom the computer 102, as well as other possibilities, are all withinthe scope of the invention.

Now referring to FIG. 7, in conjunction with FIGS. 4-6, operations 300of the multimedia audiometer 100 and the software driving thoseoperations 300 are discussed. When power is supplied to the multimediaaudiometer 100, the basic audiometer 200, as well as the computer 102,may perform various set-up functions 302. Those set-up functions 302 ofthe multimedia audiometer 100, for example, boot-up and initializationof the computer 102 and start-up and initialization of the basicaudiometer 200, are conventional. The start-up and initialization of thebasic audiometer 200 may be substantially the same as that of theconventional audiometer 2 (shown in FIG. 1).

Generally, this start-up and initialization of the basic audiometer 200may proceed, for example, as follows:

At turn-on, the basic audiometer 200 presents a first tone and a messageappears on the display 18. The basic audiometer 200 is now ready foroperation. If a processing error by the CPU 12 is discovered during theturn-on, an appropriate message is displayed. The following exampleillustrates an initialization procedure for the basic audiometer 200.Keys of the keyboard 20 are indicated by [] and messages in quotes. Tobegin, press: KEYBOARD DISPLAY [SPECIAL] SPC00 [ENTER] MM DD YY Nowenter today's date. For example: KEYBOARD DISPLAY COMMENT [04 30 96] OMDD YY

The message “mode pulsed” then appears on the display 18. Press [NO] toswitch to continuous mode. “Continuous Mode” will be displayed. Press[ENTER] when the desired code is displayed. The display should now read“1KL AA AUTO” and then displays “PRESS [NEW TEST]”. Other parameterswhich maybe selected include the test other ear first and delete 8000Hz. To do this, press: KEYBOARD DISPLAY COMMENT [SPECIAL] SPC 04 [04]SPC 04 [ENTER] LEFT EAR FIRST [NO] RIGHT EAR FIRST [ENTER] 1KR AA AUTO(Now testing right ear first) [SPECIAL] SPC 06 [06] SPC 06 [ENTER] 8KRSEL AUTO [NO] 8KR DEL AUTO [ENTER] 1KR AA AUTO (8 Khz is deleted)

The basic audiometer 200 is now initialized. Any or all of theabove-mentioned parameters can be changed at any time by entering adesired special routine. Various “Special” codes that may be possiblewith the basic audiometer 200 of the multimedia audiometer 100 may, forexample, include the following: SPECIAL FUNCTION 00 Initialization ofaudiometer 01 Enter date and time 02 Mode Pulsed/Continuous 03 EnterExaminer ID 04 Invent runtable to test better ear first 05 SelectPrinter Format 06 Select or Delete 8K 07 Select Baud rate 08 Turn on oroff audio feedback for key pushes 09 Accelerated listening check 10Check calibration date 11 Call Ram Rock check 12 Calibration mode andprogram calibration eeprom 13 Printer Text 14 Not used 15 Displayroutine for time and date (no entry) 16 Not used 17 Display selectedaudiogram 18 Print selected audiogram or audiograms 19 Display and/orenter serial number 20 Not used

Software protocols to accomplish the start-up and initialization of thebasic audiometer 200 may be stored in the memory 14, 16 of the basicaudiometer 200 or elsewhere. Processing and control for the start-up andinitialization of the set-up functions 302 are performed by the CPU 12of the basic audiometer 200. Alternatively, the basic audiometer 200could be controlled by the computer 102 to perform the start-up andinitialization, or start-up and initialization could be controlledmanually or in some other manner.

After the set-up functions 302, including start-up and initialization ofthe basic audiometer 200, are completed, the basic audiometer 200 may beready to begin administering anew audiometric test of a test subject.Anew test may be begun, for example, by pressing a key of the basicaudiometer 200 or, alternatively, by a similar input to the computer102. Upon the start of the new test, the computer 102 may control thebasic audiometer 200 by communications over the communications interface108 (shown in FIGS. 4-5).

If initial instructions to the test subject are desired, the computer102 may control 304 the basic audiometer 200 over the communicationsinterface 108 (shown in FIGS. 4-5). This control 304 may trigger therelay 64 a and the relays 64 b (shown in FIG. 2) to close the switches66 a and open the switches 66 b (shown in FIG. 2), respectively. Whenthe switches 66 a are closed and the switches 66 b are opened in thismanner, sound signals passed to the sound port 120 from the computer 102over the multimedia input interface 110 are delivered through theamplifier 69 of the multimedia talkover card 118 b and through theearphone jack 48 to the earphone speakers 50.

The particular sound signals so passed to the earphone speakers 50 maybe derived from digital information stored or generated in, or read by,the computer 102. The computer 102 may select and output 306 signalsrepresentative of the particular digital information. If the testing isjust beginning, the signals so selected and output 306 may be initialinstructions to the test subject about the test and the testingprocedure. Of course, the particular signals could be representative ofvirtually any type of information which is subject to derivation fromdigital data. Although sound is described here as being derived fromdigital data, those skilled in the art will know and appreciate thatdigital data may be manipulated and processed in a multitude of ways toderive other types of information, for example, visual graphics andimages and others.

After the computer has selected and output 306 the desired sound signalsto the basic audiometer 200 and signals have been delivered to the testsubject as sound waves through the earphone speakers 50, the computer102, again may control 308 the basic audiometer 200. The control 308 atthis instant may trigger the relay 64 a to close the switches 66 a andthe relays 66 b (shown in FIG. 2) to open the switches 66 b,respectively. The control 308, then, causes the basic audiometer 200 togenerate 310 a series of test tones, such as, for example, tones inaccordance with the Hughson-Westlake procedure or another testingprotocol.

When the switches 66 a are closed and the switches 66 b are openedbecause of the control 308, the test tones generated 310 by the audiocircuitry 6 of the basic audiometer 200 are delivered through theearphone jack 48 to the earphone speakers 50. According to theparticular testing protocol, the test subject may respond to the testtones by input 312 via the handswitch 52 connected to the basicaudiometer 200. The basic audiometer 200, in cooperation with thecomputer 102, will detect and determine any error 314 of the input 312response.

If there is not any error 316, then the basic audiometer 200 maycontinue to generate successive test tones 320 according to theparticular test protocol, until the test is completed 322. Thesuccessive test tones 320 are generated in the same manner as previouslydescribed. That is, the basic audiometer 200 operates to generate testtones 310 delivered to the test subject; the test subject responds withinput 312 via the handswitch 52; and the audiometer 200, in conjunctionwith the computer 102, detects and determines 314 any error.

If an error 318 is detected and determined 314, the computer 102, basedon its particular programmed logic, determines 324 whether to proceed326 with the testing, to re-test 328, or to perform some other function(not shown). Certain errors that maybe encountered during theadministration of the test include, for example, the following:

No response at 1 kHz, Error Code E1, signifies that the test subject isnot responding to the test tone. The test subject may receive amultimedia sound message, generated by the computer 102 and passedthrough the earphone speakers 50, as to how to take the test, forexample, as follows:

-   -   “There has been no response for any tone in the initial test—as        soon as you hear a tone cut it off by pressing and releasing the        hand switch.”

Then, the test may be restarted.

Failed to Establish Threshold, Error Code E2, signifies that the basicaudiometer 200 is unable to establish a hearing threshold level (HTL)from the response of the test subject. The test subject may beinstructed based on digital data of the computer 102, for example, asfollows:

-   -   “The audiometer has been unable to establish a threshold—listen        for the tone and as soon as you hear the tone cut it off by        pressing and releasing the hand switch.”

The test may then recommence.

Hand Switch Error, Error Code E4, signifies that the test subject is notreleasing the response handswitch 52. The test subject may, for example,receive the following instructions generated from the digital datastored by computer 102:

-   -   “The audiometer is recognizing the hand switch as being on for a        length of time—as soon as you hear a tone cut it off by pressing        and releasing the hand switch.”

The test may then recommence.

Response no tone, Error Code E5, signifies that the test subject hasresponded at least three times when no tone or stimulus was present. Amultimedia message, for example, as follows, maybe delivered through theearphone speakers 50:

-   -   “The audiometer is recognizing responses when no tone is        present—as soon as you hear a tone cut it off by pressing and        releasing the hand switch.”

The test is, thereafter, restarted.

The foregoing error codes, multimedia messages, and operations aremerely example possibilities. An example of an entire error code list isas follows: Error Multimedia Audiometer Code Indication Response AA NotTested DD Deleted Frequency EE No Response Test Continues EF TestIncomplete EB 25 Presentations Test Continues No HTL E1 No ResponseStops Test Repeat 1 KHz Instructions E2 1 KHz 25 Stops Test RepeatPresentations No Instructions HTL E3 1 KHz Retest Stops Test RepeatError Instructions E4 Hand Switch Stops Test Holding Error Switch MSG E5Response No Tone Stops Test Response w/window closed E6 Error For SecondStops Test Examiner Time Intervention E7 Max. Failed Stops Test ExaminerFrequencies > 6 Intervention E8 Hardware Error Only seen at Turnon andAfter EPROM Diagnostic CheckError Codes That Do Not Stop TestEEError Codes that Get Instructions and Resume TestingEB-Same as E2 messageE1E2E4E5Error Codes That Stop Test and Pop Up Message on PC forOperator Test Does Not RestartE3E6E7

In the case that a re-test 328 is warranted because of an error orotherwise, the operations 300 begin anew with the computer control 304of the basic audiometer 200 over the communications interface 108 (shownin FIGS. 4-5) to trigger the relays 64 a,b. The testing thereafterproceeds through the steps of selections and output 306, computercontrol 308, test tone generation 310, test subject response input 312,and detection and error determination 314.

Once the entire test protocol is completed in the foregoing manner, thetest is completed 322. The computer 102 may then control 330 the basicaudiometer 200 to trigger the relays 64 a,b to close the switches 66 aand to open the switches 66 b. The control 330 is accomplished in themanners previously described by communications between the computer 102and the basic audiometer 200 over the communications interface 108.

After the control 330 so sets the switches 66 a,b, the computer 102 mayfurther select and output 340 sound signals, which sound signals arederived from digital data stored, generated or read by the computer 102.The sound signals may travel to the earphone jack 48 and the earphonespeakers 50 to deliver final instructions and messages to the testsubject.

Numerous alternatives and variations are possible for the multimediaaudiometer 100. For example, digital data stored, generated or read bythe computer 102 may be representative of a wide variety of sounds,images, video, or other multimedia features. In certain embodiments, theparticular digital data may allow the test subject to select any of anumber of different languages through which testing is administered.Further, digital data may be manipulated by the computer 102 in such amanner that multiple simultaneous tests maybe administered. There are,of course, numerous other possibilities.

There are also many possible variations and alternatives in theconfiguration of the computer 102 and the basic audiometer 200 byproviding the audiometer with additional memory, processing, wave soundgeneration, and appropriate software. Alternatively, the computer 102could include a test tone generation means and appropriate softwareprogramming to perform the functions of the basic audiometer 200. Evenfurther, the multimedia audiometer 100 could be implemented by using aprogrammable digital tape player or compact disc (CD) player andallowing the basic audiometer 200 to select desired tracks to play.Other alternatives may be possible, it being understood that thoseskilled in the art will generally know and appreciate that theemployment of computer or other control of instrumentation operationsduring test, administration and the use of multimedia features forinstruction, messages, and other here before required humanadministrative actions is possible with the incorporation of digitaldata, according to the embodiments of the present invention, from whichare derived multimedia features.

It is to be understood that multiple variations, changes andmodifications are possible in the aforementioned embodiments of theinvention. Although illustrative embodiments of the invention have beenshown and described, a wide range of modification, change, andsubstitution is contemplated in the foregoing disclosure and, in someinstances, some features of the present invention may be employedwithout a corresponding use of the other features. Accordingly, it isappropriate that the foregoing description be construed broadly andunderstood as being given by way of illustration and example only, thespirit and scope of the invention being limited only by the appendedclaims.

Although the present invention has been described with reference topreferred embodiments, workers skilled in the art will recognize thatchanges maybe made in form and detail without departing from the spiritand scope of the invention.

1. A method of obtaining data related to hearing ability of a subject,comprising: outputting tones or sounds; monitoring the subject'sresponses to the tones or sounds; detecting an error condition based onthe responses; automatically delivering corrective instructions based onthe error condition detected; resuming the outputting of tones orsounds; and iterating selected ones of the steps of outputting,monitoring, detecting, automatically delivering and resuming until thedata related to hearing ability of the subject has been obtained.
 2. Themethod of claim 1, wherein the steps of outputting tones or sounds andmonitoring the subject's responses to the tones or sounds are performedaccording to a logical testing procedure.
 3. The method of claim 2,wherein the logical testing procedure is the Hughson-Westlake procedure.4. The method of claim 1, wherein the corrective instructions areaudible instructions.
 5. The method of claim 1, wherein the correctiveinstructions are visual instructions.
 6. A method of performing anaudiometric test of a subject, comprising: generating audible testtones; monitoring responses by the subject; detecting errors in thesubject's responses to the audible test tones; automatically producingselected corrective instructions in response to the detected errors; andcompiling and storing the responses of the test subject in a memory. 7.The method of claim 6, wherein the steps of generating audible testtones and monitoring the subject's responses are performed according toa logical testing procedure.
 8. The method of claim 7, wherein thelogical testing procedure is the Hughson-Westlake procedure.
 9. Themethod of claim 6, wherein the selected corrective instructions areaudible instructions.
 10. The method of claim 6, wherein the selectedcorrective instructions are visual instructions.
 11. The method of claim6, further comprising: displaying and/or printing results of theaudiometric test.
 12. A method of obtaining audiometric test data,comprising: administering an audiometric test, including iterativelyperforming the steps of: outputting audible test tones; monitoring asubject's responses to the test tones; detecting errors in the subject'sresponses; and automatically delivering corrective instructions inresponse to errors detected in the subject's responses; and processingand storing the audiometric test data based on the subject's responsesto the test tones and any corrective instructions delivered to thesubject in response to errors detected in the subject's responses. 13.The method of claim 12, wherein the steps of outputting audible testtones and monitoring the subject's responses to the test tones areperformed according to a logical testing procedure.
 14. The method ofclaim 13, wherein the logical testing procedure is the Hughson-Westlakeprocedure.
 15. The method of claim 12, wherein the correctiveinstructions are audible instructions.
 16. The method of claim 12,wherein the corrective instructions are visual instructions.
 17. Themethod of claim 12, further comprising: displaying and/or printing theaudiometric test data.